Class 4: ODSP Medical Reviews
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1. What are medical reviews?
Medical review is the term that ODSP uses for an eligibility review of your patient's medical conditions. During a medical review, ODSP checks that your patient still meets their definition of a person with a disability.
2. Why do medical reviews happen?
By law, everyone is scheduled for a medical review, unless it is certain their medical condition will never improve. Patients with terminal diagnoses, intellectual disabilities, or severe degenerative conditions may not get a medical review, but most other patients do.
3. When do medical reviews happen?
The interval for the medical review is set when the ODSP application is initially approved. It could be anywhere from six months to ten years.
When it's time to do the medical review, your patient will be notified by letter. They will have 90 days to complete the review, but they can ask for an extension if needed.
4. What's required to complete the medical review?
The medical review paperwork has to be completed by a physician, nurse practitioner, registered nurse, or psychologist. It does not have to be completed by the same person that did the initial application.
The medical review forms are different than the initial ODSP application forms. On medical review, ODSP is looking to see if there has been any improvement to your patient's conditions since the initial application. If nothing has changed, or their condition has gotten worse, then the medical review should be approved, and ODSP benefits should continue. But, if ODSP finds there has been improvement, the medical review may be denied, and your patient's ODSP benefits will stop.
If the medical review is denied, remember to prescribe legal help: your patient should be referred to their local legal clinic.